Medicare AEP (Annual Election Period) is upon us and time to say goodbye to Blue Cross Smart Value plans. In many parts of GA the Smart Value Classic and Smart Value Plus will not be available in 2012. That means you must make some decisions.
Because Smart Value plans are going away you have a GUARANTEED RIGHT to move to another plan without submitting to medical underwriting. You CAN NOT BE TURNED DOWN.
Do you want to jump to another Advantage plan that may go away next year or would you rather return to the security of original Medicare and a Medicare supplement plan?
Advantage Plans Become More Expensive Every Year
Congress is constantly looking for ways to save money and one way they are doing that is to reduce funding while placing more demands on Medicare Advantage plans.
Each year carriers withdraw Advantage plans from the market because government red tape makes in impossible for them to offer a competitive product that meets government guidelines and is profitable. The result for you, a senior in Georgia, is to once again make a decision on a plan for the next year.
Life is much more simple when you have Medicare and a Medigap plan.
Replacing Blue Cross Smart Value
If you want another Advantage plan you will need to find another carrier. Depending on where you live in Georgia, finding a replacement plan may be difficult.
You will probably be better off with original Medicare and a plan such as Medigap plan N.
Plan N works like this.
Your Medicare approved doctor submits your claim direct to Medicare. After Medicare approves the claim they submit it to your Medigap carrier.
If your doctor accepts Medicare assignment they will also accept your Medigap plan regardless of the plan or carrier.
If Medicare approves the claim your Medigap carrier MUST pay their portion, no questions asked.
Medigap plan N pays your Medicare Part A (hospital) deductible and any coinsurance. When Medicare approves your Part A benefits, your gap carrier MUST pay the balance.
Medicare supplement plan N requires you to pay your Part B deductible ($162 in 2011). After your annual Part B deductible is satisfied, you are obligated to pay a copay of up to $20 for each doctor visit for the balance of the year.
If you go to the Emergency Room, you are obligated to pay up to $50 for each ER visit.
That’s it.
Not a lot of moving parts.
Easy to understand.
Many will find replacing the Blue Cross Smart Value with Medigap plan N to be a wise choice.
Direct or Use a Medicare Specialist?
As with any coverage, you can go direct to a carrier or allow an independent agent that specializes in Medicare plans to assist.
When you go direct here is what to expect.
You can only call during certain hours.
Your call will almost always be answered by a robot where you will be instructed to “Press 1 for English.”
From there you will be routed to voice mail, or if you are lucky, you will speak to a human. That person may or may not be able to answer your question. If you don’t know the right questions to ask you will never know if you are getting the right answer or not.
Every time you talk to a human you will get a different person.
Or you can use a specialist . . .
When you use an independent agent that person can answer questions about several plans with several carriers, not just one.
You will have one contact, not many who are faceless and nameless.
If your Medicare specialist does not know the answer they will find out and get back with you, usually within 24 hours or less.
Your Medicare specialist has the same plans and same rates as going direct. The carrier pays your agent a service fee in return for assisting in finding a plan that fits your needs and budget.
Same plans. Same rates. Same person each time.
Bob Vineyard and Georgia Medicare Plans offer competitive Medigap rates from all major carriers and all standardized plans including Medigap plan N.
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